Thalassemia

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Dr Bahadoram
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Patient document

اهورا احمدفخرالدین

Monthly Tests

#	Test Date

Quarterly Tests

#	Test Date

Half-Yearly tests

#	Test Date

Yearly tests

#	Test Date

General Information

First Name

Last Name

National Code

Date of Birth

Mobile or Telephone

Gender

Province

City

Ethnicity

Weight in K.G

Height in C.M

Blood Group Type

Rh+

Rh-

Kell+

Kell-

Kidd+

Kidd-

Duffy+

Duffy-

E+

E-

e+

e-

C+

C-

c+

c-

Enter other Blood Group Systems:

Disease

Diagnosis (Dx)

Dx Type

Xmn1

Alpha(α) Mutation Type

Beta(β) Mutation Type

Hb Electrophoresis

Hb Electrophoresis Test Date

hbA

hbA2

hbC

hbE

hbF

hbS

hbBart

hbD

hbG

hbH

hbJ

hbM

Sexual maturation rate

Description ون ویلبراند تیپ 2